HomeMy WebLinkAboutRBPR-07-2013-17740.TIFTHIS IS NOT A PERMIT Case # RBPR-07-2013-17740
CATAWBA COUNTY HEALTH DEPARTMENT �_.
PLAN REVIEW APPLICATION FOR ENVIRONMENTAL SERVICES
Residential Building Plan Review - Manufactured Home ti • . - d
IMPROVEMENT
Applicant RICARDO CATINGUB, 1500 MACO RD, LELAND NC 28451
C:9105234920
Contractor DIAMOND HOMES, 6255 E NC 150 HWY DENVER NC 28037
C:7044892145
Land Owner MONTY MOORE, 3801 BUFFALO SHOALS RD, MAIDEN NC 28650
H:704-201-9771 HOME:704-201-9771
NAME TO APPEAR ON PERMIT
Ricardo Catingub
SITE ADDRESS: 3532 ABERNATHY WILLIAMS RD, MAIDEN NC 28650 PIN #
NAME of SUBDIVISION: Lot #
PROPERTY SIZE: Square Feet Acres 1
H
C-7
366704533986
SectionBlock
DIRECTIONS: Hwy 16 S, right on Buffalo Shoalds Rd, go about 2-3 miles, right on Abernathy Williams site (dirt rd) site up right about
150 yards, existing sw w wood siding currently on property
PRIMARY CONTACT: Contractor SEWER TYPE: Septic Tank
GALLONS PER DAY: 360 WATER SUPPLY: N/A
DESCRIBE WORK: 28x64 DW to replace 14x80 SW, same (3) # of bdrms
SITE INFORMATION
Do any of the following apply to the property for which this application is applied?
If the answer to any of the questions below is "YES", then supporting documentation is required:
Does this site contain any jurisdictional wetlands? No
Does this site contain any existing wastewater systems? Yes
Is any of the wastewater going to be generated on the site other than domestic sewage? No
Is the site subject to approval by any other public agency? Yes
Are there any easements or right-of-ways on this property?
APPLICATION FOR: New Structure
STRUCTURE TYPE: PRIMARY RESIDENCE
FACILITY TYPE: Mobile Home OTHER DESCRIPTION:
DESCRIPTION OF single wide mobile home
EXISTING STRUCTURES
ON SITE (IF ANY)
DIM EXISTING STRUCTURE: 18x80
NUMBER OF EXISTING BEDROOMS: 3 # OF OCCUPANTS: 2
PROPOSED CONSTRUCTION
NEW STRUCTURE DIM:: 28x64
# OF NEW BEDROOMS:: 3
Desired system types (Improvement Permit or Authorization to Construct):
ACCEPTED: ALTERNATIVE: CONVENTIONAL:
OTHER: INNOVATIVE: ANY: YES
Other described:
E9 - chapplicatum 07/26/2013 11:01 Pagel of 4
IgA CATAWBA COUNTY Case # RBPR-07-2013-17740
1 Public Health Department Subdivision
v �bo Environmental Health Division PIN# 366704533986
PO Boa 389, 100-A Southwest Blvd, Newton, NC 28658
I� 2 SM
NAME ON PERMIT: RICARDO CATINGUB, 1500 MACO RD, LELAND NC 28451
Site Address: 3532 ABERNATHY WILLIAMS RD, MAIDEN NC 28650
Property Size: Square Feet Acres 1
Directions: Hwy 16 S, right on Buffalo Shoalds Rd, go about 2-3 miles, right on Abernathy Williams site (dirt rd) site up right about
150 yards, existing sw w wood siding currently on property
Improvement Permits issued as a result of this information are valid for 5 years or may be non -expiring under certain specified conditions. An
Authorization to Construct issued by this department is valid for (5) five years from the date issued and is not transferable; Improvement Permits and Well
Permits are transferrable. Permits may be revoked if the information on this application, site plans or intended use changes for the proposed facility.
I have read this application and certify that the information provided herein is true, complete and correct. Authorized county and state officials are granted
right of entry to conduct necessary inspections to determine compliance with applicable laws nd r les. I understand tWafin�date.
lely responsible for the
proper identification and beling of all property lines and corners and making the site acc s o that a complete sin can be performed.
Date: �%�� (�/ 3 Signature of Applicant or AgentAn Environmental Health Specialist will contact you witht -2 working days of appl
If you need further information or assistance please call 828-466-7291
AREA1
MINIMUM SETBACKS FRONT: SIDE: REAR: MAX HEIGHT:
FEENAME DATE FEE AMOUNT
Improvement Permit Fee 07/26/2013 $150.00
TOTAL FEES $150.00
SYSTEM REDESIGN AND/OR RETRIP WILL INCUR AN ADDITIONAL CHARGE
(SEE FEE SCHEDULE)
1-9 - ehapplication 07/26/2013 11:01 Page 2 of 4
CA-TAWBA'- l
THIS IS NOT A PERMIT ff- 1�
cour} CATAWBA COUNTY HEALTH DEPARTMENT
e"' nti�mro,F�� Application for Environmental Services Page l
Improvement Permit [Authorization to Construct ❑ Septic Repair ❑ Septic Malfunction ❑
Septic Expansion ❑ New Well Permit ❑ Replacement Well ❑ Well Abandonment ❑
Well Repair ❑ Existing System Inspection (Pre -Approval Required) ❑
Application is for New Construction ❑ Existing Facility ❑
Property Address 302 JG�� �1/�?�1CllAi%2_� IV Subdivision
—
M4 !1f G� :2 �t (a. �`�� Lot # Acres
r
f Section/Block/Phase
Driving Directions to Property S 9�7 11, ga �S�j l ,( L jou,,, x %4' Os
u� �I
641 /AcI w! "ds �(cxi5 i ina I�r We t-9 A)Cod s OLeYt
NAME TO APPEAR ON PERMIT? �wner ❑ Applicant ❑ Contractor r&." #,W)
Applicant Contact Information / �'
Name L"A`flN� it d� /t$ awe ( t�% —Ji? Am . -,m,
Address
j Phone I - qr p q -a 3 _ t1g 20 Cell Phone
Owner Contact Information
Name I/ M` 4 ljfdv!`�
Address 3 yb I ' fg' a r&v .4 467�,f5
Phone I Cell Phone •��� _ �0I - �'%'7�
Contractor Contact Information
Name IriclY1a' ri7i)�te S
Address
Phone -70((— c(� �j _ j r��'" r ( Cell Phone
WHO WILL BE THE PRIMARY CONTACT? ❑ Owner ❑ Applicant 63-ontractor
Description of Existing Structures on Site Sr+q tent : r 6&
# of Bedrooms *t , � Structure Dimensions 5�0 # of Occupants
Basement ❑ Yes 91io Basement Fixtures ❑ Yes 0 -56 -
The Applicant shall notify the local health department upon submittal of this application if any of the following apply to
the property fi question. If the answer to any question is "yes", applicant must attach supporting documentation.
❑ es 1:1 No Does the site contain any jurisdictional wetlands?
lk/yes 0 No Does the site contain any existing wastewater systems?
❑ Yes IkNo Is any wastewater going to be generated on the site other than domestic sewage?
19/Yes ,N% Is the site subject to approval by any other public agency?
❑ Yes [No Are there an
ieasements or right of ways on this property? Describe
Existing water supply in use ( Individual Well U Community Well U Semi -Public Well
❑ County/City/Township Water Line Is a public water supply available? ** ❑ Yes ❑ No
If applying for an Improvement Permit or Authorization to Construct, Please Indicate Desired System Type(s):
(systems can be ranked in order of your preference)
0 Accepted , 11 Alternative D Conventional 0 Innovative 0 Other 0 Any
CATAWBA. THIS IS NOT A PERMIT
IN
CATAWBA COUNTY HEALTH DEPARTMENT
N�„„Caro Application for Environmental Services
Esed Facility Type
Primary Residence ❑ New Residence [J Addition to Residence # of New Bedrooms
*�
Project Description w , til,
Structure Dimensions �2 ' X &Y, # of Occupants ,-
Basement ❑ Yes [_2"No Basement Fixtures ❑ Yes ETI�o
U Accessory Structure(s) Describe
# of New Bedrooms *f if applicable Structure Dimensions
# of Occupants Accessory Dwelling ❑ Yes ❑ No
Plumbing ❑ Yes ❑ No Describe Plumbing Needed
U Multi -Family Residence # Units #Bedrooms per Unit*t
Total # Bedrooms *f Structure Dimensions
H Food Service Specify Type
# Seats Floor Space -Entire Food Service Facility (Sq Ft)
# Employees per Shift # of Shifts Dining Area (Sq. Ft.)
H Business Specific Type of Business Retail Floor Space
# of Employees per Shift # of Shifts
❑ Other Facility Type Specify
If Church # of Seats Kitchen ❑ Yes ❑ No If Daycare Specify Occupancy
Application for Well Construction/Abandonment/Repair
Proposed Well Type ❑ Individual Well ❑ Semi -Public Well ❑ Community Well
Abandonment Type ❑ Drilled ❑ Bored ❑ Dug ❑ Unknown
Well Repair Requested ❑ Yes ❑ No Describe
Page 2
Calculated Design Flow, Commercial `}• Additional information may be required to determine
design flow from certain facilities. This value will be determined during consultation with on-site staff.
*Any room that will be intended for sleeping at the time of construction or for future consideration should be noted as a bedroom and
counted on all applications. The number of bedrooms will be confirmed by rooms identified on house plans as a bedroom at the time
of building permit issuance. This may prevent the need for septic system size increase in the future.
t If structure is plumbed but no bedrooms, calculated design flow is required.
** If No, a well permit must be issued with the Authorization to Construct.
SYSTEM REDESIGN AND/OR RETRIP WILL INCUR AN ADDITIONAL CHARGE (SEE FEE SCHEDULE)
Improvement Permits issued as a result of this information are valid for 5 years or may be non -expiring under certain specified
conditions. An Authorization to Construct issued by this department is valid for (5) five years from the date issued and is not
transferable; Improvement Permits and Well Permits are transferrable. Permits may be revoked if the information on this application,
site plans or intended use changes for the proposed facility.
I have read this application and certify that the information provided herein is true, complete and correct. Authorized county and state
officials arc granted right of entry to conduct necessary inspections to determine compliance with applicable laws and rules. I
understand that I am solely responsible for the proper identification and labeling of all property lines and corners and making the site
accessible so that a complete site evaluation can be performed.
Signature of Owner or Agent Date
Printed Name of Owner or Agent—_�,�,4�►ri7.ctr,.�/B
N
I inch = 60 feet
)3A
193
Catawba County, North Carolina
This map product was prepared from the Catawba County, NC, Geospatial Information System,
Catawba County has made substantial efforts to ensure the accuracy of location and labeling information
contained on this snap Catawba County promotes and recommends the independent verification of any
data contained on this map product by the user. The County of Catawba, its employees, agents and
personnel disclaim, and shall not be held liable for any and all damages, loss or liability, whether direct, indirect
or consequential which arises or may arise from this map product or the use thereof by any person or entity
Selected Parcel Number: 3667-04-53-3986
Prepared for:
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THIS IS NOT A LEGAL DOCUMENT
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Date: 7/26/�201�3 •Time:, 10:46:49 AM
CATAWBA COUNTY NC - Parcel Report
Information Regarding Selected Parcel(s)
Parcel ID:
3667-04-53-3986
Name:
MOORE MONTY ROLSON
Name2:
Address:
3801 BUFFALO SHOALS RD
Address2:
City:
MAIDEN
State:
NC
Zip:
28650-9128
Account:
Calc Acreage:
1
Tax Map:
LRK:
200353
Deed Book:
2002E
Deed Page:
0758
Subdivision Name:
Subdivision Block:
Lots:
Plat Book:
55
Plat Page:
145
Building Number:
3532
Street Name:
ABERNATHY WILLIAMS RD
Site Zip:
28650
Township:
CALDWELL
Fire Dist:
BANDYS
City/Tax:
State Road:
Total Bldgs Value:
Land Value:
$9,500
Total Value:
$9,500
Year Built:
Year Remodeled:
Last Sale Date:
Last Sale Amount:
Neighborhood:
113
Watershed:
WS -II Protected Area
Watershed Split:
NO
Voter Precinct:
P9
E911 District:
COUNTY
Zoning:
R-40
Zoning2:
Zoning3:
Zoning Split:
N
Zoning Overlay: WP -O
Zoning District:
COUNTY
Split Zoning Dist:
N
Split Zoning Dist(1):
0
Split Zoning Dist(2):
0
School District:
COUNTY
Elementary School:
TUTTLE
Middle School:
MAIDEN
High School:
MAIDEN
School Split:
NO
P&Z Case Number:
Census Tract 2010: 011602
Census Block 2010: 4001
Small Area Plan:
BALLS CREEK
Agricultural District:
Printed: Friday, July
26, 2013 10:46 AM
***Op. Permit and/or Cert. Op. Required (Must be completed prior to final) N-0 i'' 8 3 2 8
CATAWBA COUNTY .'HEALTH DEBARTMEN"qTT
(704) 465-8270
Lot Eval.-KImprove. PermitRepair Permit Cert. of Comp. Permit Oper. Permit
Owner/Agent 1f Aw"e. Phone Li Z1V - 9 w `i
AddressRajpp.tr, SiS Subdivision
VVL{E}-)! 6iQ EAC- Section/Block/Phase Lot#_
Lot Size j Y}L Directions: 16 S CLZ) 3t- Ff-ALo 5i+ob a-cS ( i2t,) A6 -,r J -*-L,
W 1 ( ")" S Lot 905 (-+ Oti PJO W.. 'r `
Facility: House Mobile Home_ Business Other: Tax Map #--e
Multi -family Other Zoning Approval # �TarJdO`Z5`-i
Bedrooms ,� Seats Employees Application Rate c ''1 GPD Flow 360
Hot Tub or Spa yes/no Special Fixtures 100% Repair Area yes/no REPAIR NOTICE:
Basement yes/0 Basement Plumbing yes/no REPAIRS MUST BE WITHIN 30 DAYS OR
Water Supply: Private X Public DAYS FROM DATE OF PERMIT.
Type of System: Trench X Bed Pump Pump/Panel Panel LPP Other
Tank Size: Septic Tank loco c n k Pump Tank
Nitrification Field: Total Square Feet � 00 Depth of Stone 1Z. Bed Size
Trench Width 36 Total Length of All Trenches 300 Number of Trenches _.?
Individual Trench Length (00 / 100 / t0() / / Feet on Center—9 Maximum Trench Depth Zq
Distance of Nearest Well So Lot Evaluation: Approved(Ces/no (Void After 24 months)
Topo 2-3 %.Slope Sketch of lot Evaluation Site - System Design - Final
Texture C Icy 2,4 DO NOT
INSTALL
Structure R-LonK y WHEN WET
Clay Min. l /
Soil Wetness
Soil Depth > Yr "
Restric. Hoz. at — "
Available space /nol
Overall Class S(Tyu
Comments:
3,0 --
Septic Tank Contractors
MUST contact the
Sanitarian BEFORE
changing permit.
**NO GUARANTEE OR WARRANTY IS IMPLIED OR GIVEN THROUGH THE ISSUANCE OF THIS PERMIT**
Permit Date Z5,-_el5 (Improvement Permit v ter 60 months)
Owner/Agent //( /% Sanitarian //
Installed By �� Date �f�Cj'�.S Sanitarian
(Note 4ny changes/information in red or by sketch on bac
*******IF A PERMIT HAS TO BE REDESIGNED AND/OR RETRIPS MADE TO THE PROPERTY, THERE IS AN*******
ADDITIONAL S25 CHARGE.